Individual provider Active NPI

Marie-Helene Gagnon, M.D.

  • Pediatric Radiology Physician
  • Atlanta, GA
National Provider Identifier
1902253966
Registry record updated Mar 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Radiology PhysicianTaxonomy code 2085P0229X
License
88587 Issued in GA
Practice address
1405 Clifton Rd NE
Atlanta, GA 30322-3720
Phone
(404) 785-3655
NPI assigned
May 19, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 29, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MT210764 PA
Pediatric Radiology Physician 2085P0229X 88587 GA Primary

Addresses

Primary practice location

1405 Clifton Rd NE
Atlanta, GA 30322-3720

Mailing address

1200 Old York Rd
Abington, PA 19001-3720

Other practice location 1

1200 Old York Rd
Abington, PA 19001-3720
Phone (215) 481-2191

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220629003223 GA Practitioner - Diagnostic Radiology 8628360484 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MT210764PAMDInternal Medicine Physician
88587GAMDPediatric Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Emory Medical Care Foundation Inc Pediatric Radiology CurrentSince Jul 1, 2022 Accepting new patients
The Emory Clinic Inc Internal Medicine CurrentSince Jul 1, 2022 Accepting new patients
Emory Medical Care Foundation Inc Internal Medicine Current Accepting new patients

Locations

1405 Clifton Rd NE
Atlanta, GA 30322
Phone (404) 785-1112

2201 Henderson Mill Rd NE
Ste 160
Atlanta, GA 30345
Phone (404) 251-2193

1365 Clifton Rd NE
Atlanta, GA 30322
Phone (404) 778-7525

80 Jesse Hill Jr Dr SE
Atlanta, GA 30303
Phone (404) 616-4370

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1463616000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648512000000",
    "number": "1902253966",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 OLD YORK RD",
            "city": "ABINGTON",
            "state": "PA",
            "postal_code": "190013720"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1405 CLIFTON RD NE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303223720",
            "telephone_number": "404-785-3655"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1200 Old York Rd",
            "address_purpose": "LOCATION",
            "city": "Abington",
            "state": "PA",
            "postal_code": "190013720",
            "country_code": "US",
            "telephone_number": "215-481-2191",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GAGNON",
        "first_name": "MARIE-HELENE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-05-19",
        "last_updated": "2022-03-29",
        "certification_date": "2022-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MT210764",
            "primary": false
        },
        {
            "code": "2085P0229X",
            "taxonomy_group": "",
            "desc": "Radiology, Pediatric Radiology",
            "state": "GA",
            "license": "88587",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.